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La exención de Medicaid

In May 2021, the Division of Disability and Rehabilitative Services launched Case Management Innovation as part of our BDDS Waiver Redesign efforts.

Through this initiative, BDDS is utilizing a (b)(4) fee-for-service waiver structure that allows states to limit the number of providers. DDRS will select case management entities to serve waiver consumers beginning in January of 2022 through a Request for Services process. Case management entities interested in serving individuals receiving supports through BDDS’ waivers will be required to submit proposals. A third-party vendor is leading this process to ensure all proposals are scored solely on their merits and without prejudice. A pre-determined number of case management entities with the highest scores will be selected to provide services through no-cost contracts. Payments for services will continue through Indiana Medicaid.

Additionally, BDDS is developing a quality guide for case management entities and case managers that will provide technical assistance in various formats that will include what to do, how to do it, and most importantly, why the task or activity is important. Additional training and a more robust certification exam are also being developed to move BDDS closer to its desired goals.

To promote a continual increase in quality, BDDS is introducing value-based, non-financial incentives to reward case management entities for attaining pre-determined goals. Awards of value-based incentives will not be made until 2023 to allow for the development of baseline metrics.

This page was last updated on 5/5/21.

This information has been copied directly from the DDRS website.

FAQs for Individuals and Families

What is the Medicaid Waiver?

The Indiana Medicaid Waiver (sometimes known as the Home and Community-Based Services Waiver) is a state-funded program which pays for supports and services for individuals with disabilities in their family homes or provider-owned communities overseen by the Bureau of Developmental Disabilities Services (BDDS). Medicaid Waivers allow an individual to use traditional Medicaid services, as well as additional services offered through the Medicaid Waiver program. The program began in 1981 in response to the national trend toward providing home and community-based services. In the past, Medicaid paid only for institutionally based long-term care services, such as nursing facilities and group homes. As described by BDDS, the goals of waiver services are to provide the individual with meaningful and necessary services and supports, to respect the individual’s personal beliefs and customs, and to ensure that services are cost effective. Specifically, waivers for individuals with an intellectual/developmental disability assist an individual to:

  • Become integrated into the community where he or she lives and works
  • Develop social relationships within the person’s home and work communities
  • Develop skills to make decisions about how and where the individual wants to live
  • Be as independent as possible
There are two types of the Medicaid Waiver available to individuals who qualify in Indiana: The Family Supports Waiver (FSW) and the Community Integration and Habilitation (CIH) Waiver. Both waiver options provide services to participants with an intellectual disability, cerebral palsy, epilepsy, autism, or other condition (other than a sole diagnosis of mental illness) similar to intellectual disability who have substantial functional limitations. Participants may choose to live in their own home, family home, or community setting appropriate to their needs. The difference in waivers depends on the severity of the individual's required supports. To qualify for the Indiana Medicaid Waiver, per Indiana Code IC 12-7-2-61, an individual’s developmental disability diagnosis is required to meet the following conditions:
  • Is attributable to:

    • Intellectual/developmental disability, cerebral palsy, epilepsy, or autism, or

    • Any other condition (other than a sole diagnosis of mental illness) found to be closely related to intellectual/developmental disability, because this condition results in similar impairment of general intellectual/developmental functioning or adaptive behavior, or requires treatment or services similar to those required for a person with an intellectual/developmental disability.

  • Is manifested before the individual is 22 years of age

  • Is likely to continue indefinitely

  • Results in substantial functional limitations in at least three of the following areas of major life activities:

    • Self-care

    • Understanding and use of language

    • Learning

    • Mobility

    • Self-direction

    • Capacity for independent living

    • Economic self-sufficiency

Other things to note:
  • If applying for the Medicaid Waiver and over the age of 18, you must apply for Social Security Income (SSI) or Social Security Disability Income (SSDI)
  • If you are under the age of 18, a separate eligibility assessment is completed, after the application is received.
  • For the Family Supports Waiver, funding is limited to $17,300 per year for services.
  • For the Community Integration and Habilitation (CIH) Waiver, funding caps are based on the person’s needs and residential setting as determined by DDRS.

How Do I Apply for the Medicaid Waiver?

You can apply for the Medicaid Waiver through your local Bureau of Developmental Disability Services (BDDS) office. Obtain the number for your local BDDS office by calling 800-545-7763 or utilize this BDDS District Map to find your local BDDS office.

What Services are offered through the Medicaid Waiver?

  • Adult Day Services

  • Behavioral Therapy

  • Case Management (Required)

  • Community-Based Habilitation – Group or Individual

  • Environmental Modifications

  • Extended Services

  • Facility-Based Habilitation – Group or Individual

  • Music Therapy

  • Participant Assistance and Care (FS Waiver Only)

  • Personal Emergency Response System

  • Prevocational Services

  • Recreational Therapy

  • Residential Habilitation (CIH Waiver Only)

  • Respite

  • Structured Family Caregiving (CIH Waiver Only)

  • Transportation

  • Wellness Coordination (CIH Waiver Only)

  • Workplace Assistance

For more information regarding descriptions of each service, please see the most recent DDRS Manual.

Why are the case management changes a new priority?

Case management services are a vital function. DDRS is prioritizing case management services and responding to stakeholder requests for enhancements as part of the overall waiver redesign process. Additionally, it’s important that case management uphold quality standards, which are being prioritized as part of this initiative.

Is this the waiver redesign?

Yes. This innovation is PART of the waiver redesign. During the waiver redesign process, we received feedback that improvements are needed in case management training and consistency and that this should be addressed separately from other waiver services. With these identified needs and available approaches, we have started an initiative known as Case Management Innovation.

Will I still be able to choose my case manager and case management company?

Yes. You have the ability to choose your provider of all waiver services and to select a different provider at any time.

Can I keep my same case manager?

If your case manager already works for one of the case management companies selected through this process, then keeping your same case manager is likely. If your case manager works for a case management company that is NOT awarded, you will have to choose a new case management company, which may mean working with a new case manager.

What will happen if my case manager is not part of an awarded case management entity and I have to choose a new one?

BDDS is working with all the current case management companies to ensure that a smooth transition exists and that individuals have the information they need to choose a case management company that is right for them.

Am I going to lose to my waiver?

No. This does not affect your eligibility or access to the waiver.

Will this affect my budget?

No. There is no change to the reimbursement for case management. Therefore, it has no affect to your waiver budget.

Will I lose any services?

No. You will have the same options for waiver services as you currently have.

How is this different than the case management I currently receive?

The quality and delivery of person-centered case management services will be directly and positively impacted. This model gives case managers the tools and resources to connect individuals and families to an array of supports to help them define and advocate for their vision of a good life. For instance, your case manager may have more support and better training, and you may see greater consistency in the case management service.

I live in a rural area – will this make it harder for me to get a case manager?

No. BDDS is working to ensure that no matter where you live, you will have your choice of case management companies.

What do I need to do now?

No action is needed. All individuals currently receiving CIH and FSW services will be notified via email of new information when it’s available, including any next steps.

Where can I find more information?

There are multiple ways you can stay up to date and receive the latest information. - The BDDS Waiver Redesign webpage includes announcements, resources and opportunities for feedback. - The BDDS Case Management Innovation webpage provides information specific to this case management initiative. - Sign up for DDRS emails to have all announcements sent directly to your inbox. - Follow the BDDS Facebook page for posts and for our FB Live every other Friday. - Subscribe to the INvision newsletter, a quarterly newsletter for individuals and families.

Who should I talk to with my questions or concerns related to my case manager?

BDDS and BQIS is prohibited in answering questions related directly to the RFS but are still available to answer questions related to the overall project of waiver redesign. Questions, concerns or general feedback can be directed to your local BDDS office or you can email DDRSwaivernoticecomment@fssa.IN.gov.

What is the timeline for changes?

The case management companies’ contracts will be awarded in October, and the anticipated implementation date is in January 2022.